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IntroductionIn recent years hypertension has become an emerging condition in the young population. It has been proposed that the renin–angiotensin system plays an important role in regulation of blood pressure. We assessed whether activation of the intrarenal renin-angiotensin system occurs in hypertensive children and adolescents and what better reflects its activity: urine angiotensinogen (AGT) or urine renin (REN).Material and methodsThe study was conducted on a sample of 58 subjects with primary hypertension (HT) and 29 normotensive children and adolescents. We measured urine REN and AGT excretion and assessed the values in relation to blood pressure (BP) and other clinical parameters. Both REN and AGT values were calculated by urine creatinine: REN/cr. and AGT/cr., respectively.ResultsWe observed higher urine REN/cr. values in hypertensive subjects in comparison to the reference group (6.99 vs. 2.93, p = 0.003). Hypertensive participants showed positive correlations between urine REN/cr. and diastolic 24-hour BP (r = 0.42, p = 0.002) as well as between urine REN/cr. and urine AGT/cr. (r = 0.266, p = 0.044, respectively).ConclusionsIncreased urine REN/cr. in hypertensive children and adolescents and its positive correlation with BP may indicate its important role in the pathogenesis of HT. Perhaps urine REN/cr. could be a marker of intrarenal renin-angiotensin system activity. Nevertheless, further research should be undertaken to confirm this observation.

Aim: The plasma homeostasis of both free and esterified carnitines is mostly regulated by renal tubular reabsorption, which may be disturbed in low birth weight children. The aim of study was to ch...

Introduction The number of obese people is increasing, and its negative impact on the people’s health is significant. The relationship between physical activity and obesity is still under investigation. One of components responsible for the metabolism are adipokines such as adropin or adiponectin. The purpose of this study was to investigate, whether the controlled physical activity affects the concentrations of adipokines and may play role in treatment of obesity in children. Material and Methods 34 obese children aged 5–18 years were involved to the dynamic prospective study. The reference group consisted of 16 healthy children. The participants were informed about recommended physical activity, adjusted for sex, age, and degree of overweight. They were equipped with exercise recorder for a period of 8 weeks. Before start of the study and after 8 weeks of effort, has been made anthropometric measurements, electrical bioimpedance and blood serum was collected. Adropin and adiponectin concentrations in serum were determined by ELISA. Results In the study group, 22 children decreased BMI Z-score. Average BMI Z-score has decreased from 2.75±0.43 at baseline to 2.51±0.31 at the end of the study (p Conclusions Controlled physical activity leads to reduction of obesity in children and increases serum adropine concentration, which may play role in prevention of obesity complications.

High fluid intake has been universally recommended for kidney stone prophylaxis. We evaluated 24-h urine osmolality regarded as the best biomarker of optimal hydration and upper metastable limit osmolality after water evaporation from urine sample to the onset of spontaneous crystallization and its usefulness as a new risk index that would describe an individual lithogenic potential. We collected 24-h urine from 257 pediatric patients with kidney stones and 270 controls. After volume and osmolality assessment, the urine samples were subjected to volume reduction in vacuum rotavapor continued to the onset of an induced urinary crystallization. The upper metastable limit osmolality of urine sample was calculated based on its initial osmolality value and the amount of water reduction. Pediatric stone formers presented with higher urine volume and lower urine osmolality than healthy controls. Despite that, their urine samples required much lower volume reduction to induce the spontaneous crystallization than those of controls. The ROC analysis revealed an AUC for the upper metastable limit osmolality of 0.9300 (95% CI 0.9104-0.9496) for distinguishing between stone formers and healthy subjects. At the cutoff of 2696 mOsm/kg, the test provided sensitivity and specificity of 0.8638 and 0.8189, respectively. 24-h urine osmolality provided the information about current hydration status, whereas evaporation test estimated the urinary potential to crystalize dependent on urine composition. Upper metastable limit osmolality may estimate the individual lithogenic capability and identify people at risk to stone formation when exposed to dehydration.

Background There are indications that obesity and hyperuricemia may influence the formation and composition of urinary stones. The aim of our study was to determine the effect of obesity and hyperuricemia on the urinary lithogenic risk profile in a large cohort of pediatric patients. Methods The study population comprised 478 children with urolithiasis and 517 healthy children (reference group). We studied the effects of obesity on the lithogenic profile by dividing the patients with urolithiasis into two groups based on body mass index Z-score (patients who were overweight/obese vs. those with normal weight for age) and comparing the two groups. To study the effect of hyperuricemia on the lithogenic profile, we divided the patients with urolithiasis into two groups based on the presence or not of hyperuricemia (110 patients with urolithiasis accompanied by hyperuricemia vs. 368 patients with urolithiasis and normal serum uric acid levels) and compared the groups. Results Among the children and adolescents with urolithiasis and hyperuricemia, there was a significantly lower excretion of crystallization inhibitors (citrates, magnesium). We also found significantly negative correlations between serum uric acid levels and the urine citrate/creatinine ratio (citrate/cr.; r = −0.30, p

Purpose Chemo- and radiotherapy used in acute lymphoblastic leukemia (ALL) can influence on brain functioning in the future. In a prospective study we analysed the cognitive functions of ALL survivors in relation to Tau protein as a marker of white matter injury. Material and methods Thirty-one survivors of childhood ALL (6.3 years after diagnosis); without the signs of CNS involvement, treated with chemotherapy alone, rested in first remission; underwent Intelligence tests- Wechsler Intelligence Scales (WISC-R, WAIS-R). Their results were analyzed in relation to the levels of Tau in cerebrospinal fluid (CSF) obtained during the treatment. Results The analysis showed that all survivors attained the average scores in intelligence tests. A negative correlation was found between methotrexate (MTX) doses and Freedom from Distractibility (FFD). Females had higher values of Performance Intelligence Quotient (PIQ) than males. A negative correlation was noted of Tau protein levels obtained from the last CSF with: Total and Verbal Intelligence Quotient, PIQ, Perceptual Organisation Index and FFD but not with Verbal Comprehension Index. Conclusion Our results suggest the possibility of white matter injury during the treatment for ALL with chemotherapy alone. Elevated Tau protein level in CSF at the end of treatment might indicate future difficulties in neurocognitive functioning.

To examine the association between hematological indices and serum uric acid in adolescents with hyperuricemia. 10-year retrospective cohort study of 607 patients with hyperuricemia registered with the Pediatric Nephrology Department. There was a statistically significant positive correlation between serum uric acid levels and BMI Z-scores (r=0.406, P

In this study the authors addressed the question whether neurotoxicity due to the chemotherapy of acute lymphoblastic leukemia (ALL) is associated with cerebrospinal fluid (CSF) oxidative stress. Examination of 38 ALL patients revealed significant increases in 8-isoprostane concentration and important decreases in total antioxidative capacity of CSF during therapy. The mean 8-isoprostane level at diagnosis was 9.05 +/- 1.62 pg/mL, and no correlations with initial leukocytosis, organomegaly, and lactate dehydrogenase levels were noted. 8-Isoprostane concentrations were increased on the 59th day of treatment (mean level: 24.85 +/- 7.59 pg/mL [P.01]) and remained elevated at 4 points of the consolidation phase (17.28 +/- 2.16 pg/mL [P.05]; 22.72 +/- 6.04 pg/mL [P.05]; 24.92 +/- 6.31 pg/mL [P.01]; 32.32 +/- 7.94 pg/mL [P.01]) as compared to their level at diagnosis. The mean total antioxidative capacity at diagnosis was 203.08 +/- 6.17 mumol/L and was remarkably decreased on the 59th day of treatment (189.76 +/- 1.9 mumol/L [P.05]) and at one point of the consolidation phase (188.29 +/- 3.46 mumol/L [P.05]) as compared to the level at diagnosis. This study indicates that neurotoxicity of standard ALL treatment may be related to oxidative stress.

Background The number of survivors of childhood cancer has increased. Several studies in children and adults have shown relationships between lean mass (LM), fat mass (FM), and bone mineral content (BMC). The objective of the study was to examine the association between body composition and bone mass in young survivors of childhood cancer. Methods Sixty-eight postpubertal participants (31 females and 37 males) aged between 15.5 and 27 years who were at least 5 years after completion of treatment for leukemia (n = 30), lymphoma (n = 28), or solid tumors (n = 10) were studied. Anthropometry was performed and dual energy X-ray absorptiometry (DXA) was used to assess BMC in the total body (T) and lumbar spine (S), FM, and LM. Results There were no observed differences in age or time for cessation of treatment. Body mass index (BMI) was a strong determinant of bone mass in both sexes. TBMC correlated positively with LM (males r = 0.9 and females r = 0.76; P

Objective: The aim of this study was to investigate if Symmetric Dimethylarginine (SDMA) is a sensitive biomarker of renal function and may predict subclinical kidney injury in low birth weight (LBW) children.Methods: We studied 68 LBW children and 20 children as reference group. An enzyme-linked immunosorbent assay was used to measure serum SDMA and Cystatin C (Cys C).Results: SDMA levels were higher in study groups compared to reference groups. There was a strong correlation between SDMA and Cys C, also SDMA negatively correlated with eGFR.Conclusion: Elevated SDMA concentration may play an important role in pathogenesis of chronic kidney disease.

The aim of this study was to ascertain whether changes in the concentrations of cerebrospinal fluid excitatory amino acids (EAAs) contribute to neurotoxicity of the standard acute lymphoblastic leukaemia (ALL) treatment protocols. We found a statistically significant increase in glutamate and aspartate in 12 ALL patients during their treatment. Cognitive functioning was examined in all patients at an average of 3.7 years after the disease diagnosis. Importantly, the levels of EAAs during the therapy were not correlated with the results of the cognitive test. This study suggests that standard ALL treatment-induced neurotoxicity may not lead to persistent neurocognitive deficits.

The aim of the study was to investigate the levels of cerebrospinal fluid (CSF) cytokines during chemotherapy of acute lymphoblastic leukaemia (ALL). Examination of 12 ALL child (6 boys and 6 girls) patients evidenced significant increases in interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) after induction treatment and significant increases in IL-6, tumour necrosis factor-α (TNF-α) and MCP-1 levels during the consolidation phase, as compared to their values at the time of diagnosis. There were no significant differences in CSF IL-6, TNF-α and MCP-1 concentrations after therapy. Our data suggest that standard ALL treatment may cause a subclinical inflammation and neurotoxicity.

The aim of the study was to assess whether cerebrospinal fluid tau protein is associated with cognitive changes in children with acute lymphoblastic leukemia (ALL). Examination of 38 ALL patients revealed a statistically significant increase in tau protein on treatment day 59 and at two points during consolidation phase. Cognitive functioning was examined in 19 patients at an average of 3.7 years after diagnosis. The level of tau at the initiation of maintenance therapy was negatively correlated with verbal abilities measured on an intellectual scale. The study suggests that standard ALL treatment may cause a decline in cognitive functioning. Pediatr Blood Cancer 2009;53:105–108. © 2009 Wiley-Liss, Inc.

The aim of the study was the analysis of biochemical markers of bone turnover in children with neoplasms comparing with the group of healthy children. We explored the relationships between sex, pubertal development and type of neoplastic disease. 85 children (53 boys) with newly diagnosed neoplasms: 48 with acute lymphoblastic leukaemia (ALL), 13 with Hodgkin's disease and 22 with solid tumors (group I) and 111 healthy children (group II) were studied. We measured in plasma: 1. bone specific alkaline phosphatase (BALP), 2. osteocalcin (OST) as the markers of bone formation and 3. ICTP (cross-linked telopeptide of type 1 collagen), 4. parathormon (PTH), as the markers of bone resorption.1. In the group of boys with neoplasms osteocalcin and BALP values were lower than in healthy boys: OST 51.2 ng/ml +/- 35.3 vs 85.8 ng/ml +/- 35.96, p0.0001, BALP 105.6 U/L +/- 56.8, p0.0001. The girls had lowered values of osteocalcin (45.55 ng/ml +/- 40.9 vs 71.94 ng/ml +/- 28.75, p0.0008) and ICTP (11.25 U/L +/- 3.38 vs 15,47 U/L +/- 5.33, p0.0016). The differences were also observed in comparison with the pubertal stage except for the boys in V0Tanner stage. 2. The values of OST and BALP were lower in children with ALL than in the children with solid tumours (p0.01). The values of ICTP did not depend on the type of disease, sex and pubertal stage, except the children before puberty. 3. In all group we found the correlation between OST and ICTP (r = 0.45, p0.05), BALP and ICTP (r = 0.45, p0.05). This correlation was observed in children with leukaemia (r = 0.55, p0.05), especially in girls (r = 0.9, p0.05).The markers of bone turnover are decreased in children with newly diagnosed neoplasms, especially with ALL.

Long-term neuropsychological complications such as attention and concentration disturbances, poor school performance, hyperexcitability, and even leukoencephalopathy have been described in children after chemotherapy for acute lymphoblastic leukemia. Elevation of the cerebrospinal fluid level of tau protein, associated with neuronal axons, is a neurodegenerative marker. The aim of the study was to assess the level of cerebrospinal fluid tau protein in children with acute lymphoblastic leukemia. The study included 26 patients with acute lymphoblastic leukemia and 19 patients with clinical symptoms of cerebrospinal meningitis (reference group). Tau protein levels were determined by enzyme-linked immunosorbent assay. Cerebrospinal fluid total protein level was not elevated in any of the samples. The examination was performed at diagnosis, after induction treatment, during consolidation, and after reinduction, i.e. before maintenance therapy. Neither age nor sex had an effect on tau protein levels in both groups. The mean tau protein value at diagnosis was 244.84 +/- 98.96 pg/mL in the study group (norm 300 pg/mL) and produced no correlation with initial leukocytosis, lactate dehydrogenase activity, or organomegaly at this point. Dynamic analysis revealed a statistically significant increase in tau protein after induction treatment (431.25 +/- 232.50) as compared with its level at diagnosis (244.84 +/- 98.96, P0.008) and later during treatment. The levels of tau protein at various points of treatment did not differ statistically significantly between the groups, except for the values obtained after termination of remission induction. The observed metabolic changes in tau protein, which is a known marker of neuronal damage, indicate that some patients are at a greater risk of central nervous system disorders. This finding requires further studies, also in reference to other central nervous system proteins, and confirms the necessity of long-term follow-up of leukemia patients.

Leptin plays an important role in the metabolism of adipose tissue. Considering that malignancy and its treatment cans affect normal development in childhood. We analysed the correlations between serum leptin levels and body composition after anticancer treatment. We studied 33 survivors (24 boys and 9 girls) who before our study, have been treated for acute lymphoblastic leukaemia (ALL) (n=23) and Hodgkin disease (n=10) after 7.15+/-3.5 years. Sixteen patients with ALL received cranial irradiation (12Gy). We measured body mass index (BM1) fat mass (FM) and lean body mass (LBM) using dual energy x-ray absorptiometry (DXA). We compared these results to the results obtained from reference values (SD score). Leptin levels were measured with the RIA method.1. Mean leptin levels were higher in girls after puberty (10.93 ng/mL+/-8.9) than in boys (3.73 ng/mL+/-3. 7). In boys no differences were found in leptin levels between T2-4 and T5 stages. In girls the leptin values increased after puberty. Leptin SD score levels were higher in boys during (1.55 +/-1.0) and after puberty (1.46+/-0.75) and in girls - after puberty (1.19 +/-1.51). We did not find any influence of cranial irradiation (12Gy) or various methotrexate doses (5 g/m(2) vs. 19/m(2)) leptin values. 2. No difference in BMI SD score was found within the whole study group. 3. FM did not change ill boys during and after puberty, although FM SD score were higher during puberty (2.98 +/-4.8). In girls FM and FM SD score were higher after puberty. In boys and girls LBM augmented with pubertal development but LBM SD score in boys were lower after puberty (-1.67 +/-1.7) in comparison to puberty (0.2 +/-1.7). No differences were found between LBM SD score in girls during and after puberty. 4. We found a correlation between leptin levels and BMI (r=0.59 p=0.001) and FM (r=0.77 p=0.0001). 5. Relation of FM to LBM in boys remained unchanged, however in girls it increased within pubertal development.l. Anticancer treatment during childhood shows no influence on body mass index although the tendency to higher fat mass in pubertal boys and in post pubertal girls is observed. 2. Leptin values depend on fat mass and do not relate directly to the pubertal stage.